New Guideline on HPV Vaccine for Cervical Cancer Prevention

The vaccination recommendation levels correlate to the financial resources of a region and the development of its health system.
The vaccination recommendation levels correlate to the financial resources of a region and the development of its health system.

The American Society of Clinical Oncology (ASCO) issued a new guideline on human papillomavirus (HPV) vaccination for the prevention of cervical cancer. 

The clinical practice guideline is the first for primary prevention of cervical cancer that is adapted to various areas in the world with different levels of socio-economic and structural resource settings. It includes evidence-based recommendations stratified to four levels of resource settings: basic, limited, enhanced, maximal. These levels correlate to the financial resources of a region as well as the development of its health system, which include personnel, infrastructure, and access to services. 

The major guideline recommendations are as follows:

  • In all environments and independent of the resource settings, 2 doses of HPV vaccine are recommended for girls ages 9–14 years, with an interval of at least 6 months and up to 12–15 months between doses.
  • Girls who are HIV positive should receive 3 doses.
  • If girls are ≥15 years and have received their first dose before age 15, they may complete the 2-dose series (for maximal and enhanced resource settings)
  • If they have not received the first dose before age 15, they should receive 3 doses (for maximal and enhanced resource settings)
  • In both scenarios vaccination may be given through age 26 years (for maximal and enhanced resource settings)
  • If sufficient resources remain after vaccinating girls 9 –14 years, girls who received 1 dose may receive additional doses between ages 15–26 years (for limited and basic resource settings)
  • In all settings, boys may be vaccinated, if there is ≥50% coverage in priority female target population, sufficient resources, and such vaccination is cost effective.

“Although HPV vaccine has been around for more than a decade, the uptake of the vaccine has been less than ideal in many places, including in high-resource countries such as the United States,” said Silvina Arrossi, PhD, co-chair of the Expert Panel. 

The clinical guideline was developed by a panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts who reviewed systematic reviews, existing guidelines, and cost-effective analyses. 

Reference

First Global Guidance for HPV Vaccination for Cervical Cancer Prevention [press release]. Alexandria, Virginia. American Society of Clinical Oncology. Published March 17, 2017. Accessed April 4, 2017.

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